In the course of running an endocrine diagnostic laboratory, it became apparent that a number of interfering substances which originated from endogenous or exogenous sources were becoming more of a problem in the colorimetric procedures. Numerous attempts have been made to minimize these interferences while maintaining the speed and simplicity required for a routine clinical method.
In this investigation, the possibility of interference of medications clinically utilized in Porter-Silber and Zimmermann reaction was studied. The Porter-Silber chromogen was estimated by means of a modification of the method of Reddy, Jenkins, and Thorn, and the Zimmermann chromogen by means of a modification of Sobel's method.
1) About one hundred drugs, which are administrated to the patients frequently in our hospital, were studied concerning their reactivity in these reactions, because these drugs could be the exogenous interfering substances.
2) The pure substances of these medications were reacted in vitro to phenylhydrazinesulfuric acid and meta-dinitrobenzene, and the absorption spectra of the chromogen between 350 mμ and 600 mμ were examined. In the Porter-Silber reaction the extinction of chromogen at 410 mp could be accounted for as the source of interference, and the convexity or concavity of absorption spectra between 480 mμ and 560 mμ of Zimmermann chromogen, when Allen's formula was adapted, could interfere in this reaction. In this experiment, 36 of 100 drugs were suggested to be interfering sources. These medications were as follows :
For Porter-Silber reaction :
Triacetyloleandomycin, Colimycin, Cephalothin, Erythromycin, Nystatin, Glyseofulvin, Streptomycin, Ethionamide, Trichlormethiazide, Methychlothiazide, Hydroflumethiazide, Furosemide, Spironolactone, Oxyphenbutazone, N-methylcarbamate, Carbazochrome sodium sulfate, Ca-mesoxalate, Chlorpromazine, Dipyridamole, Digitoxin. For Zimmermann reaction :
Meprobamate, Chlordiazepoxide, Tranexamic acid, Oxyphenbutazone, Priscol, Ethionamide, Triamterene, Spironolactone, N-methylcarbamate, Acetylphenolphthalein, Isovalerylphenolphthalein.
3) The recovery of these substances to organic solvents which are used for the extraction of urinary corticosteroids was investigated by adding each pure substance to controlurine specimen. The influence of each added material was examined by estimating PorterSilber and Zimmermann chromogen of each specimen. Twelve of 36 substances were recovered and were revealed to be positive or negative interference in these reactions.
4) The drugs, which could exhibit the interference in the reactions from the results mentioned above, were investigated in vivo. The examined medications were Cephalothin, Colimycin, Ethionamide, Trichlormethiazide, Methychlothiazide, N-methylcarbamate, Glyseofulvin and Triacetyloleandomycin for Porter-Silber reaction and Meprobamate, Ethionamide and Spironolactone for Zimmermann reaction. Each drug was studied in three individuals who were healthy volunteers or patients who were hospitalized for long time without any endocrine disorders. For the first three days no drugs were administrated and the urine specimens of this period were collected as control, and for the next successive three days the drug, which would be tested, was administrated at the usual dose. After the discontinuity of the drug administration, urine was collected for three further days as the control period.
5) From these in vivo studies, Cephalothin, Colimycin, Ethionamide, and Trichlormethiazide interfered in Porter-Silber reaction, and Meprobamate and Spironolactone in Zimmermann reaction.
6) Colimycin revealed interesting results. While this drug, showing an absorption maximum at 410 mi2 in vitro, was suggested to be not extracted in organic solvent from the urine in recovery experiment, the administration actually resulted large positive error in the determination of urinary Porter-Silber chromogen.
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